{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:39:05Z","timestamp":1790872745220,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cytomegalovirus continues to be a concern after transplantation despite prophylaxis regimens. Our aim was to analyse post\u2010prophylaxis primary cytomegalovirus infections among kidney transplant recipients after 6\u2010month valganciclovir prophylaxis and to determine the usefulness of surveillance after prophylaxis. Data from all cytomegalovirus D+\/R\u2010 kidney transplant recipients from January 2004 to October 2018 at our center who received 6\u2010month prophylaxis with valganciclovir were retrospectively analysed (N\u00a0=\u00a0481). Detailed analyses were performed for 136 patients who were monitored every 2\u20104\u00a0weeks for DNAemia after the discontinuation of prophylaxis. Post\u2010prophylaxis primary cytomegalovirus infection occurred in 182\/481 (38%) patients median 264\u00a0days after transplantation (IQR: 226\u2010367) and median 84\u00a0days after the end of prophylaxis (IQR: 46\u2010187). In 49% patients, cytomegalovirus infection occurred over 3 months after the end of prophylaxis. Cytomegalovirus infection was not associated with lower patient or graft survival and no independent risk factors for infection were found. From patients monitored closely, 71\/136 (52%) patients developed post\u2010prophylaxis primary cytomegalovirus infection. Altogether, 52\/136 (38%) patients were diagnosed with probable post\u2010prophylaxis cytomegalovirus disease and 19\/136 (14%) patients had asymptomatic CMV infection. Recurrent infection occurred in 38\/71 (39%) patients. The incidence of post\u2010prophylaxis primary cytomegalovirus infection among D+\/R\u2010 kidney transplant recipients remains high despite 6\u2010month prophylaxis. Surveillance after prophylaxis was challenging as a considerable portion of the infections occurred late and already symptomatic.<\/jats:p>","DOI":"10.1111\/tid.13577","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T21:17:10Z","timestamp":1612387030000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The burden of cytomegalovirus infection remains high in high\u2010risk kidney transplant recipients despite six\u2010month valganciclovir prophylaxis"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-3742","authenticated-orcid":false,"given":"Juulia","family":"R\u00e4ih\u00e4","sequence":"first","affiliation":[{"name":"Abdominal Center, Department of Transplantation and Liver Surgery Helsinki University Hospital and University of Helsinki Helsinki 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